J Neurol Surg B Skull Base 2024; 85(S 01): S1-S398
DOI: 10.1055/s-0044-1780251
Presentation Abstracts
Poster Abstracts

Surgical Approaches to Resection of Olfactory Groove Meningiomas: Comparative Meta-analysis of the Endoscopic Endonasal versus Transcranial Approaches

Authors

  • Nolan J. Brown

    1   University of California Irvine, Irvine, California, United States

  • Zach Pennington

    2   Mayo Clinic Rochester, Rochester, Minnesota, United States

  • Yusuf Mehkri

    3   Florida, United States

  • Cathleen Kuo

    4   University at Buffalo, United States

  • Sachiv Chakravarti

    5   Johns Hopkins, Baltimore, Maryland, United States

  • Julian Gendreau

    5   Johns Hopkins, Baltimore, Maryland, United States

  • Jamie J. Van Gompel

    2   Mayo Clinic Rochester, Rochester, Minnesota, United States
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Introduction: Olfactory groove meningiomas (OGM) represent roughly 8–13% of intracranial meningiomas and comprise those lesions arising from the anterior fossa in the region of the cribriform plate. Multiple approaches for the resection of these lesions have been described, with the goals of surgery being to grossly resect the lesion, maximally preserve olfactory function, and minimize frontal lobe retraction. While transcranial approaches (TCA) have historically been the standard for olfactory groove meningioma (OGM) resection, endoscopic endonasal approaches (EEA) have become increasingly popular. Here we systematically review the extant literature to highlight the advantages of EEA versus TCA for OGM, focusing on complications, extent of resection, and local recurrence rates.

Methods: PubMed, Scopus, and Web of Science databases were queried to identify all primary prospective trials and retrospective series comparing outcomes following EEA versus TCA for surgical resection of OGMs. All articles were screened against title and abstract by two independent authors; those eligible for full-text inclusion were also screened by two authors.

Results: Of 111 unique results, 3 studies comprising 53 total patients (mean age 55.0 ± 24.6 years) met criteria for inclusion in the meta-analysis: 4 compared unilateral and bilateral approaches and 3 compared EEA and TCA approaches. In the three comparing EEA (n = 21) versus TCA (n = 32), there was no significant difference between EEA and TCA with respect to GTR (OR 0.37 [0.05, 2.83], I2 = 32%, p = 0.34) or rates of Simpson Grade 1 resection (OR 1.77 [0.11, 28.97], I2 = 69, p = 0.69). Overall complication rates were similar except that TCA showed higher rates of postoperative infection [(OR 6.21 [1.19, 32.36], I2 = 0%, (p = 0.03)]. EEA was associated with a nonsignificant lower odds olfaction preservation [(OR 0.05 [0.00, 1.34], (p = 0.07).

Conclusions: Though the literature is limited, current evidence supports EEA over conventional craniotomy for olfactory groove meningioma; EEA is associated with lower complication rates and higher rates of Simpson grade I resection. Additional multi-center collaborations outlining the anatomic indications for each procedure are needed.

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
05 February 2024

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